Healthcare Provider Details

I. General information

NPI: 1053288357
Provider Name (Legal Business Name): NOCD MICHIGAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N MICHIGAN AVE STE 1430
CHICAGO IL
60601-7653
US

IV. Provider business mailing address

225 N MICHIGAN AVE STE 1430
CHICAGO IL
60601-7653
US

V. Phone/Fax

Practice location:
  • Phone: 847-436-3265
  • Fax: 312-261-5080
Mailing address:
  • Phone: 847-436-3265
  • Fax: 312-261-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LARRY TRUSKY
Title or Position: PRESIDENT
Credential:
Phone: 847-436-3265